Paediatric nephrotic syndrome
HIGH-YIELD
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Teaching point — how the wording changes the answer
A child with periorbital and pedal oedema but NO hypertension and NO haematuria points to nephrotic syndrome (most often minimal change disease), not a nephritic picture. The diagnostic triad is oedema, heavy proteinuria (>3+ or PCR >200 mg/mmol) and hypoalbuminaemia (<25 g/L). Hypertension and haematuria favour nephritic causes such as IgA nephropathy or APSGN.
Q1
Child with no preceding URTI presenting with puffy eyes and pedal oedema, no hypertension and no haematuria. Most likely diagnosis?
Key clue
Oedema without HTN or haematuria = nephrotic, not nephritic
Show answer
Nephrotic syndrome (minimal change disease)